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The Path Forward

From Current to Future-state

BCBSMA is undergoing a consumer experience transformation to build exceptional experiences for our employees and for the communities we serve.

Meet Donna

Donna is a BCBSMA member who identifies as a black, gay woman (she/her). She has her PHD, a family, and has lived in Boston since 1990. She’s also been managing multiple comorbidities since childhood, so her care roster is rather extensive. She’s constantly looking for alternative methods to manage her care, and recently, virtual has become top of mind.

3.
Plan Support

5.
Pharmacy

Donna has an acute event and seeks a new doctor who will value her lived experience. As she accesses the website, Donna sets preferences to her profile to drive how she’s engaged.

Member Outcomes

Preference, Personalization

bcbsma Outcomes

Data capture, Actionable Insights

6.
FIND CARE & COST

Through Donna’s preferred method, the back-end system directs her to find a PCP who meets her criteria. When Donna is unable to find the right PCP, BCBSMA connects her to an advocate who provides inclusive and trauma-informed care guidance.

Member Outcomes

Omni-Channel, Guidance, Collaboration

bcbsma Outcomes

Tracking, New Revenue

7.
SERVICE & CARE

When it’s time for Donna’s virtual PCP visit, her advocate joins the call. By the end of her appointment, Donna feels adequately heard, and understands what she needs to do next.

Member Outcomes

Health literacy, empowerment

bcbsma Outcomes

Cost savings, adherence, navigation

8.
Billing

2.
Enrollment & Renewal

Donna has a question about her bill and calls BCBSMA. Specialized associates – with CX informed training and the tech that provides CX empathy data at their fingertips – thoughtfully solve her problem.

Member Outcomes

Being heard, improved services

bcbsma Outcomes

Increased Satisfaction

4.
Health & Wellness

1.
Shopping

After a year, Donna has managed her health so that she is only on half of the medications she normally would take and is also off dialysis. Donna feels that BCBSMA is the ally she always needed.

Member Outcomes

Improved outcomes, cost savings

bcbsma Outcomes

Cost savings, Blue for Life / LTV